抗癫痫药课件.ppt

抗癫痫药专业知识讲座

Definitionsinepilepsy:Epilepsycomprisesrecurrentepisodesofabnormalcerebralneuronaldischarge.Theresultingseizuresareusuallyclinicallyobviousandvaryinpatternaccordingtowhichpartsofthebrainareaffected.Epilepsycanbecausedbymanyneurologicaldiseases,includinginfection,trauma,infarctionandneoplasia.Heredityhasanimportantrole(especiallyintheidiopathicgeneralisedepilepsies).

NormalbraincellAbnormalhigh-frequencydischargeFocusDrugactionInhibitdischargeStabilizemembrane,inhibitthediffusionofdischarge(primary)

CommonseizuretypesofEpilepsy:Generalisedseizures.Absence(petitmal).Tonic/clonic(grandmal).Partialseizures.Simplepartialseizures.Complexpartialseizures(temporallobeepilepsy).

Generalisedseizures:Absence(petitmal):Theseseizureshaveabruptonsetandcessation,withimpairedconsciousness,butwithnormalpostureoftenretained.TheEEGshowsatypical‘spikeandwave’pattern.Tonic/clonic(grandmal):Consciousnessisimpairedandthepatientusuallyfallstothefloor.Aphaseofmusclecontraction(‘tonic’)isfollowedbyirregularmuscleclonusandthenbysleep.Injurymayoccur.

Partialseizures:Simplepartialseizures:featuresdependonthepartofthebrainaffected,resultfromdischargeintheprecentralgyrus.Consciousnessisunimpaired.Complexpartialseizures(temporallobeepilepsy):Consciousnessisimpairedwithcomplex,oftenrepetitive,action.

TheEEGinseizureofEpilepsy3HzParadoxicaldischargeSpikewave

EpilepsyPathogenesis:Theneuroninbrainlesiondepolarizestogethersuddenly,andthenproducthigh-frequency,out-breakdischarge.Thedischargecandiffusetosurroundingnormaltissue→extensiveexcitation→thebrainfunctiontransientaberration.

NormalbraincellAbnormalhigh-frequencydischargeFocusDrugactionInhibitdischargeStabilizemembrane,inhibitthediffusionofdischarge(primary)

EpilepsyTherapeuticprinciple:Changethepermea